Therapeutic shoe for the prevention and correction of drop foot



Feb. 3, 1959 R. SWANSON 2,871,851

THERAPEUTIC suog: FOR THE PREVENTION AND CORRECTION OF DROP FOOT Filed Dec. 28. 1953 6 9.5 inn eaves 1?. 5W4A/5'0N IN VEN TOR.

Unite States Patent C THERAPEUTIC SHOE FOR THE PREVENTION AND CORRECTION OF DROP FOOT This invention relates to therapeutic appliances and has particular reference to a therapeutic shoe which finds particular utility when utilized in the prevention and treatment of the condition sometimes known as drop foot.

In the condition known as drop foot the angle between the sole of the foot and the axis of the leg is abnormally obtuse when the muscles controlling the foot position are relaxed. This condition results from unnatural elongation of certain muscles and tendons and a corresponding shortening of others. The condition is most often encountered in persons afilicted with poliomyelitis, but frequently occurs in other cases where the patent is immobilized, as, for example, in the treatment of back injuries, fractures of the lower limbs, and the like. Drop foot unless prevented or promptly corrected often results in a permanent deformity which is not only disfiguring but which also impairs and sometimes destroys the patients ability to walk.

Drop foot is prevented by holding the patients foot against dropping; that is, against movement toward the position characteristic of drop foot. Prior to this invention, this was accomplished by placing a board on edge across the bed and bracing the soles of the patients feet against the flat surface of the board. Such an arrangement has numerous disadvantages.

In the use of a board to prevent drop foot it is diflicult to properly position the board in the bed and even more difficult to firmly secure the board in the desired position. Also, there is in the use of such a board no way of holding the patients foot against the flat surface of the board, and there is nothing to prevent the patient from moving the foot away from the board as, for example, by flexing the knee joint. Finally, there is nothing in the use of such a board to prevent the rotation of the foot about the axis of the leg. This rotation must be prevented if undesirable elongation or shortening of certain muscles and tendons is to be avoided.

It is therefore an object of this invention to provide a therapeutic appliance which overcomes the above-mentioned disadvantages by holding fixed the relative positions of the foot and the leg of a patient without the use of boards or other devices secured to the bed,

It is another object of this invention to provide a therapeutic appliance of the character set forth in the preceding paragraph which comprises a shoe adapted to be worn by the patient while in bed, and which is of such configuration and construction as to hold the foot and leg of the patient in the relative position necessary to prevent drop foot.

It is another object of this invention to provide a therapeutic shoe of the character described in the preceding paragraph which includes a rigid sole attached to an upper including a high top adapted to be firmly laced about the leg above the ankle joint and disposed at an acute angle to the plane of the sole.

It is a still further object of this invention to provide 2,871,851 Patented Feb. 3, 1959 a therapeutic shoe of the character set forth in the preceding paragraphs in which the lacing extends along the front and top sides of the upper to the tip of the toe to facilitate insertion of a limp, useless, or paralyzed foot.

It is also an object of this invention to provide a therapeutic shoe of the character set forth hereinabove which includes a detachable, elongated, adjustable sole plate disposed substantially coplanar with the sole of the shoe, and adapted by engagement with the surface of the bed to hold the shoe and the foot enclosed therein against rotation about the axis of the leg.

Other objects and advantages of this invention will become apparent upon consideration of the following specification, read in connection with the accompanying drawings wherein:

Figure 1 is a side elevation of a therapeutic shoe embodying the features and principles of the invention;

Figure 2 is an underside view of the shoe illustrated in Figure 1;

Figure 3 is a fragmentary plan view of the toe portion of the shoe shown in Figure 1 and illustrating the mannor in which the lacing extends to the tip of the toe;

Figure 4 is a cross-sectional view taken substantially along the line 4-4 of Figure 2 and illustrating the attachment means used for securing the adjustable plate sole of the shoe;

Figure 5 is a bottom view of the shoe illustrated in Figure 1 showing the manner in which the adjustable sole plate cooperates with the bed to hold the patients foot against rotation about the axis of the leg; and- Figure 6 is a plan view of a modified form of sole plate adapted for use in holding both feet of a patient against angular movement about the axis of the respective legs.

Referring to the drawings, the therapeutic appliance of this invention is illustrated according to a preferred embodiment as comprising a therapeutic shoe indicated generally by the reference character 10 in Figure 1. With the exception of certain characteristics and distinguishing features hereinafter more particularly described, the shoe 10 is of substantially conventional construction including a rigid sole 11, to which is secured an upper 12. The shoe is of the heelless type with the sole 11 extending continuously to the extreme rear portion of the shoe beneath the heel portion thereof. The upper 12 which is of the high-top type may be formed and secured to the sole 11 in a conventional manner and may include a counter portion 13 adapted to encompass the back of the patients heel.

The upper 12 comprises a toe portion 14, an instep portion 15 and a leg engaging portion 16. The leg engaging portion 16 is formed substantially as shown in Figure 1 and inclines forwardly toward the toe portion 14 to a much greater extent than is characteristic of conventional shoe constructions. The upper 12 is open along the front and upper surfaces from the extreme upper end 17 of the ankle engaging portion 16 substantially to the tip of the toe portion 14 as is best shown at 18 in Figure 3. A tongue 19 of usual and conventional construction is provided and the upper is provided with a series of eyelets 20 on either side of the opening for receiving lacings 21 by means of which the shoe is secured to the foot of a patient.

The sole 11 is formed of rigid material reinforced, if desired, by an inserted metal plate or stiffener. This rigid sole cooperates with the upper 12 in such manner that when the patients foot is inserted within the shoe and the lacings 21 are used to firmly secure the legengaging portion 16 of the upper to the patients leg above the ankle joint, the patients foot will be rigidly held in a position making an acute angle between the plane of the sole of the 'foot and the axis of the leg. By opening the upper completely to the tip of the toe as described the insertion into the shoe of a patients foot is greatly facilitated, particularly in those cases where the foot is limp, useless or paralyzed. After insertion of the patients 'foot, the lacing of the shoe and the tightening of the laces as described serves to thereafter firmly hold the foot against displacement from desired corrective position.

To prevent rotation of the patents foot about the axis of the leg'to a position which might result in undesired elongation or shortening of certain muscles or tendons, the invention provides a detachable, elongated, adjustable 'sol'e plate indicated by the reference character 22 in the drawings. This plate which may be six or seven inches long and two or three inches wide is formed of relatively rigid material as, for example, metal, plastic, or stitr' sole leather. The plate 22 is detachably secured to the sole 11 by means of an attachment clip 23 which is best illustrated in Figure 4. The clip 23 comprises a flat plate 24, preferably formed of metal, positioned beneath the sole 11 and extending there-across. The lateral edges of the plate 24 are turned upwardly and inwardly to form shallow channel portions 25 adapted to partially encircle and grip the edges or welt of the sole 11. It will be found that by properly proportioning the dimensions of the plate 24 and the upturned portions 25, the clip 23 may be made to tightly fit on the sole 11 of the shoe and yet permit removal thereof by sliding the same rearwardly and off of the sole at the heel end thereof.

To the center of the clip 23 there is secured as by riveting or welding a threaded stud 26. The sole plate 22 is provided with a suitable opening substantially in the center thereof for receiving the stud 26. A wing nut 27 or similar device cooperating with the stud 26 may be used to securely clamp the sole plate 22 between the wing nut 27 and the undersurface of the clip 23. Loosening the wing nut 27 allows the sole plate 22 to be rotated about the axis of the stud 26 to any desired position, while tightening the wing nut 27 serves to hold the sole plate 22 against displacement from any desired position to which it may be adjusted.

The manner in which the sole plate 22 is utilized to hold the patents foot in a desired angular position is illustrated in Figure 5. In that figure the sole plate 22 is shown as having been adjusted to a position extending generally transverse tothe long axis of the sole 11, it being understood that in this position the wing nut 27 is tightened to prevent relative rotation between the plate 22 and the sole 11. With the patient lying on his back in bed, the heel or counter 13 of the shoe rests against the upper surface of the bed which is represented diagrammatically in Figure by the broken line 28. The lower edge surface of the plate 22 rests upon the upper surface 28 of the bed and so prevents rotation of the patients foot about the axis of the leg.

It will be appreciated that the angular position of the patients foot may be adjusted in the manner indicated by the arcuate arrow 29 in Figure 5 by loosening the wing nut 27, rotating the foot to the desired new position, and then tightening the wing nut 27.

It will be understood of course that the therapeutic shoe is made in both rights and lefts so as to be applicable to either the right or left foot of a patient or, in proper cases, to both feet. In the event it is necessary to use the therapeutic shoe of this invention on both feet of a patient, it may be found desirable to use a modified sole plate such as that shown at 22-a in Figure 6. The plate 22-a is of the same general type as the plate 22 previously described but is made somewhat longer and is provided wtih a pair of openings 30 and 31 located near the ends of the plate 22 for receiving the studs 26 of both shoes of a pair. In this way a single plate 22-a will serve to hold both of the patients feet in independently adjustable angular positions, and will also serve to hold the feet against movement toward or away from each other.

In addition to holding the patients feet in the proper preventive or corrective positions as described, the use of the therapeutic shoe of this invention makes it unnecessary to use auxiliary equipment in the patients bed for the purpose of holding the bedclothing off of the patients feet, it being recognized that due to sensitivity and 'tenderness sometimes characteristic of certain afilictions such as poliomyelitis, the use of such auxiliary equipment was necessary prior to this invention.

While the therapeutic shoe of this invention has been described with reference to the prevention and treatment of drop-foot during the time a patient is immobilized in bed, it will be appreciated that by removing the sole plate 22 and clip 23 the shoe may be worn after the patient becomes ambulatory for continuing the correction of the undesired condition. Also, for use by ambulatory patients, a conventional heel may be added to the shoe, and the forward inclination of the leg-engaging portion 16 may be reduced somewhat, as conditions may require.

From the foregoing it will be observed that this invention provides a therapeutic appliance which is effective in the prevention and correction of drop-foot Attention is directed particularly to the provision of the leg-engaging portion 16 of the upper 12. and its characteristic configuration which provides for holding the patients foot in the desired position disposing the sole of the foot at an acute angle to the leg. As previously stated, providing a laced opening extending completely to the tip of the toe of the shoe facilitates insertion of a limp or useless foot into the appliance. Attention is also directed to the provision of the removable and adjustable sole plate 22 by means of which the patients foot is held in the desired angular position for complete prevention or correction of the undesired condition.

While the preferred embodiment of this invention has been shown and described above, the invention is not to be limited to the details illustrated and described except as defined by the appended claims.

I claim:

1. A therapeutic shoe comprising a rigid sole; an upper for engaging the foot of a wearer, said upper being secured to said sole and including a leg-engaging portion for encompassing the leg of said wearer at a region above the ankle joint; means co-acting with said upper for firmly securing said leg-engaging portion to said leg, said leg-engaging portion being inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a position disposing the sole thereof at an acute angle to said leg; and a flat-elongated sole plate secured to said sole near the heel end thereof, disposed substantially coplanar with said sole and transversely of the length thereof for engaging a surface upon which the heel of said foot is rested to thereby inhibit rctation of said foot about the axis of said leg.

2. A therapeutic shoe comprising a rigid sole; an upper for engaging the foot of a wearer, said upper being secured to said sole and including a leg-engaging portion for encompassing the leg of said wearer at a region above the ankle joint; means co-acting with said upper for firmly securing said leg-engaging portion to said leg, said leg-engaging portion being inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a position disposing the sole thereof at an acute angle to said leg; a flat elongated soie plate disposed substantially coplanar with said sole near the heel end thereof and transversely of the length thereof for engaging a surface upon which the heel of said foot is rested to thereby inhibit rotation of said foot about the axis of said leg; and means detachably securing said sole plate to said sole.

3. A therapeutic shoe comprising a rigid sole; an upper for enclosing the foot of a wearer, said upper being secured to said sole and including a leg-engaging portion for encompassing the leg of said wearer at a region above the ankle joint; means co-re 'ng with said upper for firmly securing said leg-engaging portion to said leg, said leg-engaging portion being inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a position disposing the sole thereof at an acute angle to said leg; a fiat elongated sole plate disposed substantially co-planar with said sole near the heel end thereof and transversely of the length thereof for engaging a surface upon which the heel of said foot is rested to thereby inhibit rotation of said foot about the axis of said leg; mounting means mounting said sole plate on said sole for angular movement about an axis substantially perpendicular to the plane of said sole; and means co-acting with said mounting means for holding said sole plate in any angular position in which it may be placed.

4. A therapeutic shoe comprising a rigid sole; an upper for enclosing the foot of a wearer, said upper being secured to said sole and including a leg-engaging portion for encompassing the leg of said wearer at a region above the ankle joint; means co-acting with said upper for firmly securing said leg-engaging portion to said leg, said leg-engaging portion being inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a position disposing the sole thereof at an acute angle to said leg; a flat elongated sole plate disposed substantially coplanar with said sole near the heel end thereof and transversely of the length thereof for engaging a surface upon which the heel of said foot is rested to thereby inhibit rotation of said foot about the axis of said leg; mounting means mounting said sole plate on said sole for angular movement about an axis substantially perpendicular to the plane of said sole; means co-acting with said mounting means for holding said sole plate in any angular position in which it may be placed; and means detachably securing said mounting means to said sole.

5. A thereapeutic shoe comprising a rigid sole; an upper for enclosing the foot of a wearer, said upper being secured to said sole and including a leg-engaging portion for encompassing the leg of said wearer at a region above the ankle joint; means co-acting with said upper for firmly securing said leg-engaging portion to said leg, said leg-engaging portion being inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a position disposing the sole thereof at an acute angle to said leg; a clip comprising a flat plate extending across the under side of said sole and having upwardly and inwardly extending edge portions encompassing and gripping the side edges of said sole near the heel end thereof to secure said clip to said sole; and a flat elongated sole plate secured to said clip and disposed substantially coplanar with said sole and transversely of the length thereof for engaging a surface upon which the heel of said foot is rested to thereby inhibit rotation of said foot about the axisof said leg.

6. A therapeutic shoe comprising a rigid sole; an upper for enclosing the foot of a wearer, said upper being secured to said sole and including a leg-engaging portion for encompassing the leg of said wearer at a region above the ankle joint; means co-acting with said upper for firmly securing said leg-engaging portion to said leg, said leg-engaging portion being inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a position disposing the sole thereof at an acute angle to said leg; a clip comprising a flat plate extending across the underside of said sole and having upwardly and inwardly extending edge portions encompassing and gripping the side edges of said sole near the heel end thereof to secure said clip to said sole; a threaded stud secured to sizid clip and extending downwardly therefrom; a flat elongated sole plate having an opening for receiving said stud; and nut means co-acting with said studto clamp said sole plate to said clip in any adjusted position disposing said plate substantially coplanar with said sole and transversely of the length thereof for engaging a surface upon which the heel of said foot is rested to thereby inhibit rotation of said foot about the axis of said leg.

7. A therapeutic shoe comprising a rigid sole; an upper for enclosing the foot of a wearer, said upper being secured to said sole and including a leg-engaging portion for encompassing the leg of said wearer at a region above the ankle joint, said upper being opened along the top and front side thereof from the uppermost end of said leg engaging portion to a point closely adjacent the forwardmost end of said upper; means on said upper for interconnecting the edges of said upper across the opening therein to draw said edges together and secure said upper to said foot and leg, said leg engaging portion being inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a position disposing the sole thereof at an acute angle to said leg; a clip comprising a flat plate extending across the underside of said sole and having upwardly and inwardly extending edge portions encompassing and gripping the side edges of said sole to secure said clip to said sole; a threaded stud secured to said clip and ex tending downwardly therefrom; a flat elongated sole plate having an opening for receiving said stud; and nut means co-acting with said stud to clamp said sole plate to said clip in any adjusted position disposing said plate substantially coplanar with said sole and transversely of the length thereof for engaging a surface upon which the heel of said foot is rested to thereby inhibit rotation of said foot about the axis of said leg.

8. A therapeutic shoe comprising: a sole having an internal surface conformable to the sole of a normal foot; an upper secured to said sole having an opening for insertion of a foot and ankle into said shoe, said upper including a leg-engaging portion whose media-l axis is forwardly inclined for encompassing the leg of said wearer at a region above the ankle joint; and means coacting with the opening in said upper to close said shoe after said foot and ankle have been inserted therein, said means, said sole and said upper thereafter maintaining said leg-engaging portion inclined forwardly of a line normal to the plane of said sole to thereby hold the foot of said wearer in a conforming position disposing the sole thereof at an acute angle to said leg.

References Cited in the file of this patent UNITED STATES PATENTS 1,577,712 Graham Mar. 23, 1926 2,170,724 Marquardt Aug. 22, 1939 2,237,945 Minor Apr. 8, 1941 2,439,100 Richards Apr. 6, 1948 2,482,646 Brachman et al Sept. 20, 1949 2,516,872 Hauser et a1 Aug. 1, 1950 2,588,411 Robinson Mar. 11, 1952 OTHER REFERENCES The Journal of Bone and Joint Surgery for July 1936, pp. 788-9.

U. S. Armed Forces Medical Journal for July 1952, pp. 1107-10. (Copies of the above publications in the Scientific Library.)

The Journal-of Bone and Joint Surgery for April 1952, advertising, page 44. 

